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Montana rates for HCPCS Q0164

Prochlorperazine maleate, 5 mg, oral, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 48-hour dosage regimen

Facilitymedian $0 · 10th–90th $0–$10%20%40%10th90th$0Professionalmedian $0 · 10th–90th $0–$10%20%40%10th90th$0$0.1$1.0$20.0$500.0$10.0K$200.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.14 / $10.96 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.44 / $0.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.52
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.56 / $0.58
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.56 / $0.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.43 / $0.66
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.44 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.35